Integrated contrast-enhanced diagnostic whole-body PET/CT as a first-line restaging modality in patients with suspected metastatic recurrence of breast cancer

Dirisamer, Albert; Halpern, Benjamin S.; Flöry, Daniel; Wolf, Florian; Beheshti, Mohsen; Mayerhoefer, Marius E.; Langsteger, Werner

doi:10.1016/j.ejrad.2008.10.031

« Previous Next »European Journal of Radiology
Volume 73, Issue 2 , Pages 294-299, February 2010

Integrated contrast-enhanced diagnostic whole-body PET/CT as a first-line restaging modality in patients with suspected metastatic recurrence of breast cancer

Albert Dirisamer
- Department of Nuclear Medicine, St. Vincent's Hospital, Seilerstaette 4, 4010 Linz, Austria
- Department of Radiology, Medical University of Vienna, Waehringer Gürtel 18-20, 1090 Vienna, Austria
- Corresponding author at: Department of Radiology, Medical University of Vienna, Waehringer Gürtel 18-20, 1090 Vienna, Austria. Tel.: +43 1 40400 4893; fax: +43 1 40400 4894.
Benjamin S. Halpern
- Department of Radiology, Medical University of Vienna, Waehringer Gürtel 18-20, 1090 Vienna, Austria
Daniel Flöry
- Department of Radiology, General Hospital of Linz, Austria
Florian Wolf
- Department of Radiology, Medical University of Vienna, Waehringer Gürtel 18-20, 1090 Vienna, Austria
Mohsen Beheshti
- Department of Nuclear Medicine, St. Vincent's Hospital, Seilerstaette 4, 4010 Linz, Austria
Marius E. Mayerhoefer
- Department of Radiology, Medical University of Vienna, Waehringer Gürtel 18-20, 1090 Vienna, Austria
Werner Langsteger
- Department of Nuclear Medicine, St. Vincent's Hospital, Seilerstaette 4, 4010 Linz, Austria

Received 16 October 2008; received in revised form 23 October 2008; accepted 27 October 2008.

Abstract

Objective(s)

Only few information exist about the diagnostic accuracy of PET/CT for restaging patients with metastatic recurrence of breast carcinoma. Therefore, our study hypothesis was to perform diagnostic contrast enhanced CT (ce-CT) and FDG-PET in a one-step investigation, to prove sensitivity of each modality and to determine whether diagnostic PET/CT adds information over PET or contrast enhanced CT alone for restaging of patients with suspected recurrence of breast cancer.

Methods

Fifty-two patients with suspected recurrence of breast cancer were included in our study. All of them were free of metastasis after the first line therapy. Indications for restaging were: Elevated tumor markers n=32, clinical deterioration n=16 and/or suspicious findings on other imaging studies n=48. Integrated PET/CT was performed using contrast-enhanced diagnostic CT for attenuation correction.

Results

PET was correct in 44/52 patients (85%), ce-CT in 38/52 patients (73%) and PET/CT in 50/52 patients (96%). Sensitivity and specificity of lesion detection of PET, CT and PET/CT were 84%, 66% and 93%, and 100%, 92%, and 100%, respectively.

Discussion

PET/CT can improve staging and alter therapeutic options in patients suspected to have breast cancer recurrence and distant metastatic disease, primarily by demonstrating local or distant nodal involvement occult at other imaging studies. The added value of FDG-PET/CT over other diagnostic modalities is mainly expressed by the fact that a noninvasive whole-body evaluation is possible in a single examination.

Keywords: PET/CT, Breast cancer, Recurrence, FDG